Individual
MARY JANE FORREST-COSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, MS
Contact information
Practice address
104 BARNES ST, OCEANSIDE, CA 92054-3406
(760) 967-4401
Mailing address
104 BARNES ST, OCEANSIDE, CA 92054-3406
(760) 967-4401
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
795453
CA
Other
Enumeration date
10/03/2012
Last updated
10/03/2012
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